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Razor bumps and barber's rash

Dear Alice,

I hope you might be able to help me with something. It seems every time I shave my beard (or pubic hair), I break out with tiny little red bumps the very next day. I have tried many things to remedy this, aftershave, ointments, changing shaving creams and razors, changing the way I shave, yet nothing seems to work. These little bumps are quite uncomfortable, yet usually last about a week, so I know it's nothing serious. If you could give me any kind of information, I would greatly appreciate it. Thank you for your time.

— Shaved Ape

Dear Shaved Ape,

Your red bumps could be razor bumps (pseudofolliculitis barbae when facial hairs are involved; psuedofolliculitis pubis when pubic hairs are involved) or possibly barber's rash (folliculitis). Women can get razor bumps as well, whether on their bikini line, underarms, or anywhere else. However, these shaving problems are most common among men of African-Caribbean descent in particular or in people with curly hair.

Razor bumps are created when hair curls and grows back into the skin. The body's immune system recognizes the hair as an intruder and attacks it, creating red, inflamed areas. These red bumps are susceptible to infection and can easily turn into barber's rash.

Barber's rash is caused by a bacteria called Staphylococcus aureus that infects the hair follicle. This can lead to redness, itching, and even small, pus-filled blisters. The bacteria normally resides in our nasal passages without our realizing it. Shaving can introduce the bacteria to hair follicles on the face, where it isn't as harmless a guest.

Treating razor bumps and barber's rash involves letting the hair grow without shaving for three to four weeks. In that time, hair grows enough to actually "spring out" by the hair follicle. Some people find that a mild topical corticosteroid cream helps reduce inflammation and pain. Benzoyl peroxide also helps by reducing bacteria. Apply it sparingly, since it can be irritating to sensitive skin. If your barber's rash is severe, your health care provider will diagnose this and perhaps prescribe medication or antibiotics.

People can help prevent razor bumps and barber's rash by:

Using warm water to soften the skin and hairs before shaving; shaving right after a shower.

Applying shaving cream, foam, or soap in the opposite direction of hair growth (usually upward), moisturizing your skin as well as hair.

Shaving the easier areas first: the jawline, cheeks, and neck.

Shaving in the direction of hair growth (usually downward).

Not stretching your skin taut.

Rinsing your razor thoroughly after each use and replacing your blades every week or more often if necessary.

Shaving in the opposite direction of hair growth and stretching the skin taut are two methods of getting the closest shave, which unfortunately increase the likelihood of razor bumps and barber's rash. These techniques, as well as using razors with two or three blades, attempt to cut the hair underneath the actual skin line, inadvertently making it easier for those hairs to then poke back into the skin. Using an electric razor gently against the skin is another option to help prevent razor bumps or barber's rash.

In very difficult cases, health care providers might recommend chemical "shaving" products or even laser hair removal. If you do use a chemical product, begin its use only after all your bumps and lesions are gone, since the chemicals can burn, and carefully follow instructions.

If none of these shaving tips help, and your health care provider cannot make any other recommendations in your case, you might just have to go au naturel — that is, grow a beard. If this is the case, perhaps your provider can give you a medical certificate explaining your condition if your job requires you to be clean-shaven.